Education for Health Plans a Key to Success in MA Hospice Carve-In

The learning curve for carving hospice into Medicare Advantage through the value-based insurance design model is a two-way street. While providers have had to learn how to work within a managed care environment and negotiate contracts with private payers, many Medicare Advantage health plans have a lot to learn about hospices. For the past couple […]

Hospice M&A Riding High on Demographic Tailwinds, but Staff Shortages Threaten Growth

The hospice mergers and acquisitions market has been burgeoning for the last several years and continues to accelerate. Hospice leads the health care sector in terms of investor interest and valuations, but providers may hit some walls if workforce shortages worsen. Among the driving forces behind this continued acceleration include demographic tailwinds, rising demand and […]

Diamond Named Humana’s CFO, Home Business President

Humana (NYSE: HUM) has named Susan Diamond as the insurance company’s CFO as well as segment president of its home-based care business. Diamond has been in the role on an interim basis since previous CFO Brian Kane stepped down in March.  During the interim period, Diamond spearheaded the acquisition of the remaining 60% stake in […]

False Claims Case to Proceed Against Hospice Provider Southerncare

A federal False Claims Act case against hospice provider Southerncare Inc. is moving forward in the Southern District Court of Mississippi. Whistleblowers associated with the company have alleged that Southerncare submitted hospice claims to Medicare for patients who were not eligible, billed for services it did not provide and terminated an employee who raised concerns […]

Humana Set to Make Bank on Kindred at Home Hospice Spin Off, Sale

Following the close of the Kindred at Home acquisition in the third quarter, Humana Inc. (NYSE: HUM) plans to spin off and sell the company’s hospice business to capitalize on high market valuations. The company also expects to see substantial cost savings through reduced hospitalizations and skilled nursing admissions as more care moves into the […]

Justice Department, Tennessee File False Hospice Claims Suit Against Curo Health Services

The U.S. Department of Justice and the State of Tennessee have filed a consolidated complaint against Curo Health Services Holdings, Regency Healthcare Group and TNMO Healthcare, doing business as Avalon Hospice. The complaint alleged that the affiliated companies violated the False Claims Act (FCA) as well as Tennessee state laws. FCA cases often hinge on […]

Humana Approved as Direct Contracting Entity, Plans to Partner with Hospices

The U.S. Centers for Medicare & Medicaid Services (CMS) has approved Humana Inc. (NYSE: HUM) to become a direct contracting entity (DCE). The company has branded the DCE as Humana Direct Contracting Entity, Inc., which operates as Humana Care Solutions. The new DCE plans to partner with hospice and palliative care providers to improve quality […]

Humana Obtains Full Ownership of Kindred at Home in $8.1 Billion Deal

Insurance giant Humana Inc. (NYSE: HUM) has penned a definitive agreement to acquire the remaining 60% stake in Kindred at Home for $8.1 billion. Humana, which currently holds 40% ownership of the business, is purchasing the additional stake from the private equity firms TPG Capital and Welsh, Carson, Anderson & Stowe.  The $8.1 billion price […]